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Bronchopulmonary dysplasia (BPD)

What is BPD and what causes it?

Bronchopulmonary dysplasia (BPD) can affect babies born prematurely, whose lungs have not developed fully in the womb. Babies diagnosed with BPD have usually had breathing problems from birth. These usually get better with time.

What is bronchopulmonary dysplasia (BPD)?

Babies born prematurely need treatments to help their breathing. These may include oxygen and other breathing support. When they still need treatment after 36 weeks corrected age, this is bronchopulmonary dysplasia (BPD).

Bronchopulmonary dysplasia is called BPD for short:

Broncho - it affects your child’s airways

Pulmonary - it affects your child’s lungs

Dysplasia - your child’s airways and lungs are not fully developed

BPD is sometimes also called chronic lung disease of prematurity or chronic neonatal lung disease.

The word ‘chronic’ means that it’s a long-term condition. Children with BPD need treatment with oxygen, but most will no longer need it by the age of 1. Some children with BPD will develop symptoms during childhood, such as

  • coughing
  • wheezing
  • getting tired or breathless more quickly than other children when they exercise.

How common is it?

BPD affects babies born prematurely. The earlier a baby is born, the more likely they are to be affected by BPD:

  • At 23 weeks’ gestation, virtually every baby born will develop BPD
  • At 28 weeks, around 1 in 4 babies will develop BPD
  • At 30 weeks, around 1 in 100 babies will develop BPD.

How does BPD affect babies and children?

Babies born very prematurely usually have breathing problems from birth and may need treatment with:

  • a machine to support their breathing
  • surfactant and
  • oxygen. 

What is surfactant?

Surfactant is a mixture of fats and proteins that help make sure the air sacs don’t collapse when you breathe out. 

It is produced as babies’ lungs develop in the womb, but premature babies may not have enough surfactant. Replacement surfactant is given to help their lungs to develop after they are born.

You can find out more in our information about how children’s lungs grow.

BPD in infants

Your baby may go home from hospital on oxygen.  This will help them grow and stay healthy. Babies with BPD usually get better with time. Most children no longer need oxygen by the age of 1. 

Read more about treatment for BPD and what you can do to help your child.

BPD later in life

BPD can lead to problems with lung health in later life. This often depends on how severe it is and whether your baby develops any complications.  Some children will develop symptoms like coughing, wheezing and getting tired and breathless when they exercise.

In general, babies and children with BPD tend to get better as they grow older. This is because most lung growth takes place after birth and throughout childhood. However, all children are different. How fast they get better, and how much their symptoms improve, will vary from child to child. So will the amount and type of care your child will need.

It is really important that babies get enough calories to grow properly, so their lungs can develop. It is important to regularly monitor weight in babies with BPD. That’s because they use more energy for breathing than most babies, and are often smaller than average.

More information for parents of premature babies

The Bliss website has information on:

What causes BPD?

BPD happens when the lungs are underdeveloped in babies born very early. When they are born prematurely, babies have very few tiny air sacs. These are not usually mature enough to work normally.

The breathing system, including the air sacs

This diagram shows the breathing system, including the air sacs. You can find out more in our information about  how children’s lungs develop.

Premature lungs and respiratory distress syndrome (RDS)

Premature babies’ lungs are not yet fully developed. They may have fewer air sacs or less surfactant. This makes the lungs stiff and makes it harder for your baby to breathe. This causes them to develop respiratory distress syndrome (RDS).

Have a look at our information on how children’s lungs develop to help you understand more.

Oxygen and BPD

If your baby’s lungs are stiff, they may be more likely to be damaged by oxygen or ventilation treatment. But the high levels of oxygen your baby’s body needs can cause harmful chemical reactions in their lungs and this may be a factor in developing BPD.

Even though too much oxygen can cause harm, it is a crucial part of the treatment.

How is BPD diagnosed?

Your child may have a chest X-ray to diagnose BPD and check for damage to the lungs.

Your child may have their blood oxygen levels monitored using a pulse oximeter - a little device clipped onto your baby’s finger, ear or toe. This can check to make sure your baby is getting enough oxygen.

Can BPD be prevented?

BPD may happen if your baby is born before their lungs are fully developed. Steps can be taken to reduce the risk of a premature birth, but it cannot always be prevented. Our information on risks to children’s lung health talks about things that can make premature birth more likely.

If you are at risk of premature labour, you may be given steroids to help mature your baby’s lungs.

Preventing damage from breathing support

Although life-saving, some of the treatments your child might need to help them to breathe can also cause damage. Breathing support such as oxygen and ventilation may damage the air sacs and other parts of the lungs.

If your child needs oxygen or ventilation, doctors will do all they can to prevent or reduce damage. They will use gentler breathing support if possible. They may give your child replacement surfactant and medication. 

Next: What is the treatment for BPD? >

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Last medically reviewed: September 2019. Due for review: September 2022

This information uses the best available medical evidence and was produced with the support of people living with lung conditions. Find out how we produce our information. If you’d like to see our references get in touch.